Between 10% and 25% of known pregnancies end in miscarriage. Between 6% and 12% of people experience infertility and/or impaired fecundity. Let's talk about it.

Science Friday: The Right to Miscarry

Science Friday is a fun thing for me to do for this blog. Let’s face it, the material for Miscarriage Memoirs is not light, typically isn’t funny, and mostly serves as an outlet for me to get my frustration out by doing something positive in sharing stories and reminding us that we are not alone. This article is serious. It is long. But I ask you to read it anyway because the women I write about below are important.

I felt moved to write about the stories of the women of El Salvador who miscarry. El Salvador’s anti-abortion laws are so stringent that women who miscarry or suffer a stillbirth are highly suspect, and in some cases have been jailed. For murder. Chile, Dominican Republic, Honduras, and Nicaragua have similar laws. No exceptions. No abortions: not for rape, not if the mother’s health is at risk, not if the fetus has genetic issues not compatible with life.

Carmen Guadalupe Vasquez was pardoned from her 30 year sentence for aggravated murder on Wednesday. Guadalupe already served seven years of her sentence–which came down on her after suffering complications during her pregnancy resulting in her child’s death very soon after birth.

Another woman, Glenda Xiomara Cruz, went to a hospital with abdominal pain on October 30, 2012, not knowing she was pregnant. She was informed that she lost her baby, and four days later was charged with the aggravated murder of her fetus. In September 2013 she was sentenced to 10 years in prison.

To make things even more terrible, it was her abusive partner who provided testimony that she had intentionally killed the fetus. Reliable witness indeed.

In 2012, Maria Teresa Rivera had a miscarriage. She was sentenced to 40 years for aggravated murder. A witness claimed Rivera thought she might be pregnant–but that was 11 months before her miscarriage.

In early 2013, a woman named Beatriz, who had lupus and a fetus with deformations incompatible with life, endured deteriorating health during a court fight for an abortion. She gave birth via Caesarian section at 27 weeks and the baby died within hours. Beatriz is alive today, but arguably would have died had her doomed pregnancy continued to term.

Cristina Quintanilla unexpectedly gave birth to her premature baby on October 24, 2004 in her bathroom. She woke up in the hospital, and was then interrogated, handcuffed to her hospital bed, charged with manslaughter, and taken to a police cell.

Initially Quintanilla’s case was dismissed, but on appeal, the prosecution upped the ante. Now the charges were aggravated murder. She was found guilty and sentenced to 30 years in jail. Quintanilla’s sentence, luckily, was reduced the three years with the help of human rights lawyer Dennis Munoz Estanley.

El Salvador’s problems are arguably larger than the abortion issue: Munoz says that El Salvador’s courts use a presumption of guilt rather than innocence like the US. The prosecutions rely on flimsy character witnesses and dubious medical evidence.

Now El Salvador’s largely poor, uneducated population is scared to go to the hospital when faced with obstetric complications. They do not trust the doctors and nurses.

Tragically, these circumstances have contributed to suicide rising to the most common cause of death among women aged 10 to 19 in 2011. Half of of these women were pregnant. Suicide is now the third most common cause of maternal mortality in El Salvador.

From 2000-2012, more than 200 women were reported for suspected abortion. Of these women, 136 were prosecuted, 56 were convicted, most for murder, the rest for abortion. Sentences for murder convictions ranged between 12 and 35 years. These women are forced into prisons like Ilopango women’s prison. Built to house 220 women, Ilopango now holds more than 2000 prisoners. There are not enough beds for all of the prisoners.

Munoz is currently leading an effort to free 17 women from this undeserved hell–the El Salvadorian Supreme Court is considering his motion to free these women. Since 2007, Munoz has helped to free eight women jailed for “crimes” similar to those described above.

El Salvadorian politicians worry that rolling back these extreme abortion laws would cost them their jobs. They fear losing the voters and the support of the Catholic Church. Sound familiar?

These stringent anti-abortion laws are not even effective: highly restrictive abortion laws are not associated with lower abortion rates. “In Uganda, where abortion is illegal and sex education programs focus only on abstinence, the estimated abortion rate was 54 per 1,000 women in 2003, more than twice the rate in the United States, 21 per 1,000 in that year. The lowest rate, 12 per 1,000, was in Western Europe, with legal abortion and widely available contraception.” (Study. Article. Article.) But they are connected to higher maternal mortality rates, and that study does not even include the suicides mentioned above.

Women in the United States should care about what happens to these women in El Salvador because they are humans being treated unfairly. But there are reasons that hit closer to home as well.

Access to contraception in the US is not as easy as one might think. Large proportions of women who seek out contraceptives are young, women of color, low-income or uninsured and typically go to publicly funded clinics, mostly safety-net health centers. These are the same clinics that are being shuttered in across the US through TRAP (targeted regulation of abortion providers) laws.

Closure of these health centers will limit women’s access to safe abortion and contraceptives–both of which are connected to higher abortion rates.

Many people think this problem will not affect them personally. That women in the United States would never have their right to health care taken away. An article by the NY Times and a study by Paltrow and Flavin are eye-opening, and terrifying. Excerpts are below.

A Utah woman was arrested and charged with fetal homicide when one of her twins was stillborn. She was trying to avoid a Caesarean section. After a long fight, she ended up avoiding jail time.

Michelle Marie Greenup (p. 308) had a miscarriage and did not report it. After seeking out medical treatment for bleeding and stomach pain. she was locked up for over a year and charged with second-degree murder. Her medical history revealed spontaneous miscarriage at 11 to 15 weeks of pregnancy due to an injection of Depo-Provera.

Floridian Laura Pemberton was attempting a VBAC (vaginal birth after Caesarian). Doctors thought this put the baby’s life at risk, so they got a court order resulting in Pemberton’s arrest. They strapped her legs together for transport to the hospital where she was prepped for surgery as an emergency hearing proceeded to determine her fate. Pemberton was not allowed counsel; her fetus was. The Caesarian went on.

Afterwards Pemberton sued for violation of her civil rights, and lost. The court said the life of her fetus was more important than her First, Fourth, and Fourteenth Amendment rights. Pemberton had three more children vaginally afterwards.

Women who suffer from drug addiction, are pregnant, and seek out help with their addiction, like Rachael Lowe, are also subject to arrest (p. 307), rapid detox (which is more dangerous to the fetus than continued drug use (p. 307 end of page)), prescribed Xanax (a category D drug, “positive evidence of risk”), and held in a psychiatric ward–all without counsel. Lowe consequently lost her job, and her husband was forced to take a leave of absence from his.

There are dozens of other terrifying stories in the paper. And let’s not forget about the tragic story of Savita Halappanavar, who died in Ireland after being refused an abortion as she miscarried. After the fetus’s death, doctors refused to perform a life-saving “abortion” and she succumbed to septicemia after complete organ failure.

Just like in El Salvador, evidence shows that cases involving arrest, detention, and forced interventions with pregnant women disproportionally affect women of color, poor women, and homeless women. One in ten of the cases studied involved domestic violence against the pregnant woman. Scarily enough, these cases tend to come out of specific states and specific counties and hospitals within these states. For a list of which to avoid, see pages 309-311.

Not all of the people reading my blog will agree on abortion rights. But I like to believe that, just like Obama said in the SOTU on Tuesday, “Surely we can agree…that every woman should have access to the health care she needs.”

I also like to think that every woman should have the ability to choose her own way to give birth–with a doctor, midwife, doula, in a hospital, at home, in a birthing center, Caesarean, VBAC, with an epidural, without, what have you. All women should also have access to free or very low cost contraceptives as a part of a comprehensive insurance plan or access to a low cost clinic.

But most of all–the right to have a miscarriage or stillbirth and not be arrested, charged, or convicted of ANYTHING. As it has been pointed out time and time again, this is a tragedy for 99.9% of the women, and families, affected by miscarriage and stillbirth.